A 66-year-old man comes for follow-up. He has shortness of breath on exercise, which has increased over the past few months. He became unable to walk more than 200-300 meters and c... A 66-year-old man comes for follow-up. He has shortness of breath on exercise, which has increased over the past few months. He became unable to walk more than 200-300 meters and cannot climb the stairs easily. He has a history of hypertension and is currently on amlodipine 5 mg and indapamide 2.5 mg. On examination, he has bilateral basal crackles and mild pitting ankle edema. Blood pressure 188/95 mmHg, heart rate 79/min. Test results: Hb 138 g/L, Sodium 138 mmol/L, Potassium 4.4 mmol/L, Creatinine 133 μmol/L. Which of the following is the most appropriate next therapy?
Understand the Problem
The question presents a clinical scenario involving a 66-year-old man with specific health symptoms and test results. It asks for the most appropriate next therapy based on the provided medical information.
Answer
Add an ACE inhibitor or an ARB.
The most appropriate next therapy is to add an ACE inhibitor or an ARB.
Answer for screen readers
The most appropriate next therapy is to add an ACE inhibitor or an ARB.
More Information
Adding an ACE inhibitor or an ARB will help manage his hypertension and improve heart failure symptoms by reducing preload and afterload.
Tips
Avoid overlooking signs of heart failure such as crackles and edema, which are key to determining the next step in treatment.
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